Isotretinoína, Acne e Depressão: Um Estudo Prospectivo Controlado

Introduction: Acne and isotretinoin, one of its treatment, have been linked to the occurrence of depression. Our aim was to study if isotretinoin is associated with depression in a sample of acne patients followed for 6 months comparing them with acne patients under other treatment modalities and control patients without acne. Methods: One hundred individuals were included: 50 controls and 50 with acne (24 using and 26 not using isotretinoin). Patients and controls answered the Beck Depression Inventory (BDI) and the 12 Item-Short Form Health Survey for quality of life (SF-12). Acne patients repeated this evaluation in 90 and 180 days. Results: No differences were found between controls and acne patients regarding BDI results but controls performed worse in the SF-12 mental domain (p=0.004). No differences were found within the acne group between those treated and not treated with isotretinoin in the comparison of the BDI and SF-12 (mental and physical domains) in days 0. 90 and 180 (all with p>0.05). Conclusion: In this small sample isotretinoin treatment showed to be safe regarding the occurrence of depression.Introdução: Depressão tem sido atribuída à acne e a um dos seus tratamentos, a isotretinoína. O nosso objetivo foi estudar se o uso da isotretinoína está associado com a depressão numa amostra de pacientes com acne acompanhados por 6 meses, comparando-se os com pacientes com acne sem este tratamento e com indivíduos de um gripo controlo, sem acne. Métodos: Cem indivíduos foram incluídos: 50 controles e 50 com acne (24 usando e 26 não usando isotretinoína). Pacientes e controles responderam ao Inventário de Depressão de Beck (IDB) e ao SF-12 (12-Item Short-Form Health Survey ou Forma curta com 12 questões do questionário de Pesquisa de Saúde). Pacientes com acne repetiram estes questionários após 90 e 180 dias. Resultados: Indivíduos controles e pacientes com acne não mostraram diferenças quando os valores do IDB foram comparados, mas os controles tiveram um pior desempenho no SF-12 - domínio mental (p=0,004). Também não foi possível verificar diferenças entre os grupos de acne tratados e não tratados com isotretinoína quanto ao IDB e ao SF-12 nos dias 0, 90 e 180 (todos com p>0,05). Conclusão: Nesta pequena amostra o tratamento com isotretinoína se mostrou seguro no que concerne à ocorrência de depressão

Abnormalities in preoperative examinations of plastic surgery patients

Introduction: Preoperative tests (EPO) aim to detect abnormalities and give greater safety to the procedure. However, the request for these tests is still controversial, either because they do not bring about changes in conduct for the procedure or result in some harm to the patient. The objective is to assess the frequency of EPO requests and abnormalities in aesthetic plastic surgery patients, to verify what these abnormalities are, what preoperative management should be done based on the finding, and to associate the data obtained with the patient’s profile and the planned surgery. Method: Retrospective study evaluating medical records of aesthetic plastic surgery patients who underwent routine EPO in a plastic surgery hospital in 2019. Results: 978 patients were studied, and 51% had some abnormality in EPO. 93.7% were women, with a mean age of 46.5 years. 12.3 exams were performed per patient, and abnormality was observed in 6.1% of EPO. The exams that had the most abnormalities were the lipidogram (23.8%) and the cardiac evaluation (14.1%). Hypothyroidism was the most common comorbidity (18.4% of patients); 70% of diabetics had a glycemic level above the recommended level. Only 3.4% of the patients suffered a change in preoperative management due to EPO abnormality, and in 57.9% of these cases, the surgery was postponed. Test alterations were more frequent in male patients (p<0.0001). Conclusion: The performance of routine EPO showed a low frequency of altered exams (3.4%) and implied changes in the preoperative conduct of plastic surgery patients

MASP-1 and MASP-2 Serum Levels Are Associated With Worse Prognostic in Cervical Cancer Progression

Background: MBL-associated serine proteases (MASP-1, MASP-2, MASP-3, MAp-44, and MAp-19) are key factors in the activation of the lectin pathway of complement. Serum levels of these components have been associated with recurrence and poor survival of some types of cancer, such as colorectal and ovarian cancer. In this investigation, we determined the serum levels of MASP-1, MASP-2, MASP-3, MAp-44, and MAp-19 in patients with cervical cancer and cervical intraepithelial neoplasia (CIN).Methods:A total of 351 women who underwent screening for cervical cancer or treatment at the Erasto Gaertner Cancer Hospital in Curitiba-Brazil, were enrolled in the study. Based on their latest cervical colposcopy-guided biopsy results, they were divided into four groups: CIN-I: n = 52; CIN-II: n = 73; CIN-III: n = 141; and invasive cancer: n = 78. All the serum protein levels were determined by time-resolved immunofluorometric assay (TRIFMA).Results:Patients with invasive cancer presented significantly higher MASP-2, MASP-1, and MAp-19 serum levels than other groups (p &lt; 0.0001; p = 0.012; p = 0.025 respectively). No statistically significant differences in MASP-3 and MAp-44 serum levels were found between the four studied groups. In addition, high MASP-2, MASP-1, and MAp-19 serum levels were significantly associated with poor survival in patients with invasive cancer and relapse (p = 0.002, p = 0.0035 and p = 0.025, respectively).Conclusion:High MASP-2, MASP-1, and MAp-19 serum levels were associated with cervical cancer progression and worse disease prognosis. These novel findings demonstrate the involvement of the serine proteases of the lectin pathway in the pathogenesis of cervical cancer and future investigations should clarify their role in the disease process

Effects of aging and the body mass index on male sex hormones: a cross-sectional study in 701 Brazilian men

Fundamentos: Alguns estudos indicam que o índice de massa corporal (IMC) é inversamente proporcional à concentração de testosterona sérica em homens Objetivos: O objetivo deste estudo é analisar o efeito do envelhecimento e da obesidade na testosterona biodisponível total e livre, bem como nos níveis de hormônio luteinizante e globulina ligadora de hormônio sexual. Métodos: Foi realizado um estudo transversal abordando o perfil clínico e laboratorial de 701 pacientes atendidos em uma clínica privada de urologia em Ponta Grossa, Brasil, de janeiro de 2016 a dezembro de 2018. Resultados: A idade dos pacientes variou de 16 a 88 anos (média de 56,9 ± 13,62 anos). A idade não influenciou significativamente as concentrações séricas de testosterona total, exceto quando comparada a pacientes com mais de 70 anos. No entanto, foi observada diferença na testosterona livre e biodisponível (p &lt;0,05). A média de globulina de ligação aos hormônios sexuais aumentou com a idade (p &lt;0,05). Embora uma tendência à elevação da luteinização tenha sido observada em pacientes mais idosos, ela não foi significativa. Relação inversa entre testosterona total, livre e biodisponível e taxa de deficiência de testosterona (testosterona total &lt;300 ng / dL) foi observada dentro dos grupos de índice de massa corporal (p &lt;0,05). A taxa de deficiência de testosterona em indivíduos com índice de massa corporal normal foi de 21,5%, indivíduos com sobrepeso foi de 29% e em indivíduos com obesidade foi de 37%. Conclusões: O envelhecimento afetou a concentração de testosterona em homens, mais evidente ao avaliar testosterona livre e biodisponível em vez de testosterona total. A globulina de ligação aos hormônios sexuais aumentou com a idade. A obesidade foi associada à redução da testosterona total, livre e biodisponível e ao aumento da taxa de hipogonadismo.Propósitos: El objetivo de este estudio es analizar el efecto del envejecimiento y la obesidad sobre la testosterona biodisponible total libre, así como los niveles de hormona luteinizante y globulina transportadora de hormonas sexuales.Métodos: Realizamos un estudio transversal que aborda los perfiles clínicos y de laboratorio de 701 pacientes tratados en una clínica de urología privada en Ponta Grossa, Brasil, desde enero de 2016 hasta diciembre de 2018.Resultados: La edad de los pacientes varió de 16 a 88 años (media 56,9 ± 13,62 años). La edad no influyó significativamente en las concentraciones séricas de testosterona total, excepto cuando se comparó con pacientes mayores de 70 años. Sin embargo, se observó una diferencia en la testosterona libre y biodisponible (p &lt;0.05). La globulina transportadora de hormonas sexuales media aumentó con la edad (p &lt;0,05). Aunque se observó una tendencia a la elevación luteinizante en pacientes mayores, no fue estadísticamente significativa. Se observó una relación inversa entre la testosterona total, libre y biodisponible y la tasa de deficiencia de testosterona (testosterona total &lt;300 ng / dL) dentro de los grupos de índice de masa corporal (p &lt;0,05). La tasa de deficiencia de testosterona en personas con índice de masa corporal normal fue del 21,5%, las personas con sobrepeso fue del 29% y en las personas con obesidad fue del 37%.Conclusiones: El envejecimiento afectó la concentración de testosterona en los hombres, más evidente cuando se usa testosterona libre y biodisponible en lugar de testosterona total. La globulina transportadora de hormonas sexuales aumenta con la edad. La obesidad se asoció con una reducción de la testosterona total, libre y biodisponible y una mayor tasa de hipogonadismo.Background: Some studies indicated that body mass index (BMI) is inversely proportional to serum testosterone concentrations in men. Purposes: This study aimed to analyze the effects of aging and obesity on total testosterone (TT), free testosterone (FT), bioavailable testosterone (BT), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) levels. Methods: A cross-sectional study was performed to assess the clinical and laboratory profiles of 701 patients treated at a private urology clinic in Ponta Grossa, Brazil, from January 2016 to December 2018. Results: Patients’ age ranged from 16 to 88 years (mean, 56.9 ± 13.62 years). Age did not significantly influence serum TT concentrations, except compared to patients aged &gt;70 years. However, changes were observed in FT and BT (p &lt; 0.05). The mean SHBG increased with age (p &lt; 0.05). A tendency toward LH elevation was observed in older patients, but it was not statistically significant. An inverse proportional relationship between TT, FT, and BT and the testosterone deficiency rate (TT &lt; 300 ng/dL) was observed within BMI groups (p &lt; 0.05). The testosterone deficiency rate was 21.5% in individuals with normal BMI, 29% in overweight individuals, and 37% in obese individuals. Conclusions: Aging affected the testosterone concentrations in men and became increasingly evident using FT and BT instead of TT. SHBG increased with age. Obesity was associated with a decrease in TT, FT, and BT but also increased the rate of hypogonadism

Functional independence index of patients submitted to multiprofessional rehabilitation program after cerebrovascular accident

A cerebrovascular accident (CVA) can cause death or motor and functional consequences of variable intensity. This study analyzed the rate of functional independence of patients after a cerebrovascular accident and a multi professional rehabilitation program. This was a retrospective research analyzing the medical charts of middle cerebral artery stroke survivors, admitted to a public hospital at Curitiba-Paraná between 2014 and 2019. The participants were analyzed at admission and discharge using the Modified Rankin Scale (mRS). The Chi-Squared test, Mann-Whitney test and Wilcoxon tests were applied, considering p&lt;0.05%. The sample was composed of 64 patients, mainly men (56%), with a mean age of 59 years old. The main stroke sequelae were motor deficit (98%), dysarthria (51%), aphasia (46%), pain (45%) and urinary incontinence (42%). There was a significant difference between the mRS scores at admission and discharge, with greater functional independence after the proposed rehabilitation program (p &lt;0.001). It is concluded that participation in the program led to increased autonomy in self-care and daily activities for the patients.Acidente Vascular Cerebral (AVC) pode causar óbito ou sequelas motoras e funcionais de intensidade variável. O objetivo do estudo foi avaliar o índice de independência funcional de pacientes pós-Acidente Vascular Cerebral submetidos a um programa de reabilitação multiprofissional. Trata-se de estudo retrospectivo por meio de revisão dos prontuários de sobreviventes de lesão vascular na artéria cerebral média, admitidos entre 2014 e 2019 em hospital público de Curitiba - Paraná, e que foram analisados na admissão e na alta por meio da Escala de Rankin modificada (mRS). Foram aplicados teste Qui-Quadrado, Mann-Whitney e Wilcoxon, considerando p &lt; 0,05 %. A amostra, composta por 64 pacientes, teve predomínio masculino (56 %), faixa etária média de 59 anos, e apresentou como sequelas principais déficit motor (98 %), disartria (51 %), afasia (46 %), dor (45 %) e incontinência urinária (42 %). Houve diferença significativa entre os escores aferidos por meio da mRS na admissão e na alta, com maior independência funcional após realização do programa de reabilitação proposto (p &lt; 0,001). Conclui-se que a participação no programa refletiu em ganho de autonomia no autocuidado e na realização de atividades diárias pelos pacientes

Serum levels of leptin and adiponectin and clinical parameters in women with fibromyalgia and overweight/obesity

ABSTRACT Objectives The objectives of this study were to evaluate the serum levels of adipokines in women with fibromyalgia with and without overweight/obesity, and to correlate the adipokines levels with clinical parameters associated with fibromyalgia and adipose tissue mass (body fat). Subjects and methods The study included 100 women divided into four groups: (a) fibromyalgia and overweight/obesity; (b) fibromyalgia and normal weight; (c) controls and overweight/obesity; and (d) controls and normal weight. Patients and controls were evaluated for clinical, anthropometric, and fibromyalgia-related parameters. Assessments included serum levels of leptin, adiponectin, monocyte chemoattractant protein-1 (MCP-1), and C-reactive protein (CRP). Levels of adipokines were further adjusted for fat mass. Results Fibromyalgia patients with overweight/obesity or normal weight had no differences in clinical parameters. Unadjusted leptin levels were lower in fibromyalgia patients than controls, a finding that was more remarkable in fibromyalgia patients with overweight/obesity. Leptin levels had no correlation with clinical parameters of fibromyalgia or inflammation markers (MCP-1 and CRP), and adiponectin levels showed no difference between groups. Conclusions No correlation was observed between adjusted leptin levels and clinical parameters of fibromyalgia. Patients with fibromyalgia and overweight/obesity presented lower levels of leptin than controls with overweight/obesity

Effects of aging and the body mass index on male sex hormones: a cross-sectional study in 701 Brazilian men

Background: Some studies indicated that body mass index (BMI) is inversely proportional to serum testosterone concentrations in men. Purposes: This study aimed to analyze the effects of aging and obesity on total testosterone (TT), free testosterone (FT), bioavailable testosterone (BT), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) levels. Methods: A cross-sectional study was performed to assess the clinical and laboratory profiles of 701 patients treated at a private urology clinic in Ponta Grossa, Brazil, from January 2016 to December 2018. Results: Patients’ age ranged from 16 to 88 years (mean, 56.9 ± 13.62 years). Age did not significantly influence serum TT concentrations, except compared to patients aged >70 years. However, changes were observed in FT and BT (p < 0.05). The mean SHBG increased with age (p < 0.05). A tendency toward LH elevation was observed in older patients, but it was not statistically significant. An inverse proportional relationship between TT, FT, and BT and the testosterone deficiency rate (TT < 300 ng/dL) was observed within BMI groups (p < 0.05). The testosterone deficiency rate was 21.5% in individuals with normal BMI, 29% in overweight individuals, and 37% in obese individuals. Conclusions: Aging affected the testosterone concentrations in men and became increasingly evident using FT and BT instead of TT. SHBG increased with age. Obesity was associated with a decrease in TT, FT, and BT but also increased the rate of hypogonadism

Epidemiological profile of children and adolescents with oral cleft treated at a referral center in Curitiba, PR, Brazil

INTRODUCTION: Oral cleft is the second major cause of congenital anomalies and represents a major craniofacial alteration in live births. The objective of this study was to analyze the epidemiological data collected from the Center for Comprehensive Care to Individuals with Cleft Lip and Palate in the period from January 2011 to December 2014. METHODS: This retrospective study evaluated 1,262 medical records of patients with an oral cleft. After applying the inclusion and exclusion criteria, 52.7% of the medical records were included in the study. RESULTS: Among the 666 medical records, 57.4% were of male patients and 42.6% were of female patients. Of these, 34.8% of the patients had a trans-foramen cleft, 27.2% had a pre-foramen cleft, 25.8% had a post-foramen cleft, and 12.2% had another type of cleft. Patients from Curitiba and the metropolitan region constituted 36.6% of the cases, and patients from rural areas of Paraná represented 61% of the visits to the care center. The median age at the first visit of the patients from Curitiba/metropolitan region and rural areas of Paraná was 1 and 2 months, respectively. The first surgery was performed at the care center at the age of 6 months in patients from Curitiba and metropolitan region and 7 months in patients from rural areas of Paraná. CONCLUSION: There was a predominance of boys and a higher prevalence of incomplete post-foramen clefts in the total population. Despite the long distance to the care center, children from rural areas of Paraná underwent the correction surgery and were treated at the referral center with an age difference of only 1 month compared with patients who lived in Curitiba, where the care center is located